Provider Demographics
NPI:1750721940
Name:PHAIR, ANNE
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:PHAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:FERDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16256 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-2347
Mailing Address - Country:US
Mailing Address - Phone:248-207-1038
Mailing Address - Fax:
Practice Address - Street 1:729 W ANN ARBOR TRL
Practice Address - Street 2:STE 3
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-6225
Practice Address - Country:US
Practice Address - Phone:734-207-5053
Practice Address - Fax:734-207-5078
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501002982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist